ERA

Emergency Medicine

Pediatricians from the Department of Pediatrics and Alberta Health Services has collaborated and have helped create the only sub-specialized Pediatric Emergency Department, which engages in knowledge exchange and training with healthcare professionals across Alberta.
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  1. Temporal trends in pediatric mental health visits: using longitudinal data to inform emergency department health care planning [Download]

    Title: Temporal trends in pediatric mental health visits: using longitudinal data to inform emergency department health care planning
    Creator: Ali, Samina
    Description: OBJECTIVE: Understanding the temporality of mental health presentations to the emergency department (ED) during the 24-hour cycle, day of the week, and month of the year may facilitate strategic planning of ED-based mental health services. METHODS: Data on 30,656 ED presentations for mental illness, substance use, or intentional self-harm by 20,956 patients (≤ 17 years) were examined. We studied patient demography, discharge diagnosis, and time and date of presentation. RESULTS: Most pediatric mental health ED visits (66.0%) occurred after the average work and school day (after 5 PM). Presentations related to substance use and intentional self-harm steadily increased in the evening. Emergency department visits related to substance use peaked on Friday through Sunday (4723/7475; 63.2%), whereas visits for mood disorders (4127/5093; 81.0%), neurotic/stress-related disorders (5960/7989; 74.6%), and behavioral/emotional disorders (237/304; 78%) were highest during the work/school week (Monday to Friday). Visits for intentional self-harm peaked following the weekend (Monday: 771/4676; 16.5%). Summer months had fewer visits (6862/30,656; 22.4%), whereas March to May (range: 2752-2912 visits) and October to November (range: 2701-2751 visits) showed more steady peaks in volume. Most presentations by diagnostic group decreased in volume during the winter months (December to February) to increase again in the spring (March to May). CONCLUSIONS: Peak times for pediatric mental health presentations to the ED are evenings throughout the week, suggesting that mental health services for children, adolescents, and their families should be available after work and school hours, 7 days a week.
    Subjects: Emergencies/epidemiology, Emergency Service, Hospital/utilization, Mental Health Services/utilization
    Date Created: 2012/07
  2. Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta [Download]

    Title: Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta
    Creator: Newton, Amanda S.
    Description: Objective: To examine sociodemographic variations among children <18 years in (1) rates of self-harm visits to emergency departments (EDs) and (2) physician follow-up after the self-harm visit in Alberta. Methods: A retrospective, population-based cohort (2002–2011) of ED visits for self-harm by individuals <18 years was conducted using administrative databases from Alberta, Canada. Individuals were grouped by First Nations status or type of health care premium subsidy (family receipt of government subsidy, human services program subsidy, no subsidy received). Visits from 104 EDs were summarized by crude and directly standardized visit rates (DSVRs) per 100,000 individuals. Kaplan-Meier estimates for median estimated time to physician follow-up were calculated with 95% confidence intervals (CIs). Results: During the study period, visit rates decreased with the exception of children from families receiving government-sponsored program subsidy (DSVRs 163/100,000 to 250/100,000; p=0.032). First Nations children had disproportionately fewer follow-up visits compared to other children. The median time to follow-up for First Nations children was 39 days (95% CI: 32, 48) compared to 16 days for children from families receiving no subsidy (95% CI: 14, 19), who had the shortest follow-up time after an ED visit. Conclusions: Sociodemographic differences were evident in ED visit rates as well as the number of and time to physician follow-up visit. The disparities experienced by First Nations children in the follow-up period highlight an opportunity for culturally-grounded risk and needs assessment in the ED to determine and facilitate timely and appropriate follow-up care.
    Subjects: children, emergency department, follow-up, self-harm, visit rates
    Date Created: 2015/03/30
  3. A Spatial Scan Statistic for Compound Poisson Data, Using Negative Binomial Distribution and Accounting for Population Stratification [Download]

    Title: A Spatial Scan Statistic for Compound Poisson Data, Using Negative Binomial Distribution and Accounting for Population Stratification
    Creator: Chang, Hsing-Ming
    Description: Since the interest in studying spatial relations in plant populations was raised in the 1950s, much effort has been devoted to the development of methods for spatial data analysis. One such development focused on techniques for detecting spatial clusters of cases and events in the biological sciences and epidemiology during the late 1980s and the following decade. More recently, research has examined detecting clusters of correlated count data associated with health conditions of individuals. Such a method allows researchers to examine spatial relationships of disease-related events rather than just incidents or prevalent cases. We introduce a spatial scan test that identifies clusters of events in a study region. Because an individual case may have multiple (repeated) events, we base the test on a special compound Poisson model. Based on this special class (a compound Poisson representation of the negative binomial distribution), advantages in computation over the general compound Poisson model that relies on a recursive formula are realized. We illustrate our method for cluster detection on emergency department visits, where individuals may make multiple asthma-related visits. We also demonstrate the spatial scan test adjusted by key population characteristics such as sex or age.
    Subjects: spatial scan, stratification, compound Poisson, surveillance, negative binomial, cluster detection
  4. Auranofin versus placebo in rheumatoid arthritis [Download]

    Title: Auranofin versus placebo in rheumatoid arthritis
    Creator: Suarez-Almazor ME
    Subjects: Arthritis, Rheumatoid, Auranofin, Antirheumatic Agents
    Date Created: 2000
  5. Continuous versus intermittent beta-agonists for acute asthma [Download]

    Title: Continuous versus intermittent beta-agonists for acute asthma
    Creator: Camargo Jr CA
    Subjects: Inhalation, Anti-Asthmatic Agents, Administration, Asthma, Adrenergic beta-Agonists, Emergencies, Acute Disease, Randomized Controlled Trials as Topic
    Date Created: 2003
  6. Early emergency department treatment of acute asthma with systemic corticosteroids [Download]

    Title: Early emergency department treatment of acute asthma with systemic corticosteroids
    Creator: Rowe BH
    Subjects: Emergency Service, Hospital, Placebo Effect, Injections, Intramuscular, Injections, Intravenous, Administration, Oral, Glucocorticoids, Acute Disease, Randomized Controlled Trials as Topic, Asthma
    Date Created: 2001
  7. Azathioprine for treating rheumatoid arthritis [Download]

    Title: Azathioprine for treating rheumatoid arthritis
    Creator: Suarez-Almazor ME
    Subjects: Randomized Controlled Trials as Topic, Antirheumatic Agents, Arthritis, Rheumatoid, Controlled Clinical Trials as Topic, Azathioprine
    Date Created: 2000
  8. Magnesium sulfate for treating exacerbations of acute asthma in the emergency department [Download]

    Title: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department
    Creator: Rowe BH
    Subjects: Acute Disease, Adrenal Cortex Hormones, Infusions, Intravenous, Bronchodilator Agents, Drug Therapy, Combination, Emergency Service, Hospital, Magnesium Sulfate, Asthma
    Date Created: 2000
  9. Mast-cell stabilising agents to prevent exercise-induced bronchoconstriction [Download]

    Title: Mast-cell stabilising agents to prevent exercise-induced bronchoconstriction
    Creator: Spooner C
    Subjects: Asthma, Exercise-Induced, Bronchoconstriction, Adrenergic beta-Agonists, Randomized Controlled Trials as Topic, Mast Cells, Cholinergic Antagonists
    Date Created: 2003
  10. Nedocromil sodium versus sodium cromoglycate for preventing exercise-induced bronchoconstriction [Download]

    Title: Nedocromil sodium versus sodium cromoglycate for preventing exercise-induced bronchoconstriction
    Creator: Kelly KD
    Subjects: Randomized Controlled Trials as Topic, Nedocromil, Administration, Inhalation, Anti-Asthmatic Agents, Nebulizers and Vaporizers, Cromolyn Sodium, Asthma, Exercise-Induced
    Date Created: 2000